Pediatric emergency medicine trisk 2678 2678

TABLE 98.4
TUMORS AFFECTING THE CENTRAL NERVOUS SYSTEM
Location

Specific tumor types

Presenting signs
and symptoms

Comments

Supratentorial
hemispheric

Low-grade gliomas
Pilocytic
Fibrillary
High-grade glioma
Mixed neuronal-glial
neoplasms
Ganglioglioma
Ependymoma
Choroid plexus tumors
Primitive neuroectodermal
tumor (PNET)
Chiasmatic/hypothalamic
glioma
Craniopharyngioma
Germinoma/malignant
germ cell tumors
Pineoblastoma

PNET

Varies with site
Hemiparesis
Hemisensory
deficits
Seizure
Hemianopsia

Outcome for
these tumors
usually
improved by
extensive
resection

Vision deficits
Diencephalic
syndrome
Neuroendocrine
symptoms
Hydrocephalus
Parinaud
syndrome

Germinoma and
germ cell
tumors
require
biopsy;

treatment
usually
chemotherapy
not surgery

Medulloblastoma
Cerebellar astrocytoma
Ependymoma
Diffuse malignant
brainstem glioma
Benign focal brainstem
glioma

Cranial nerve
palsies
Cerebellar signs
Ataxia
Dysmetria
Brainstem signs
Weakness
Unsteady gait
Increased
intracranial
pressure

Supratentorial
midline

Infratentorial